中、大剂量阿糖胞苷治疗缓解期急性非淋巴细胞白血病的疗效探讨

Studies on the therapeutic efficacy of patients with acute myeloid leukemia in remission treated with intermediate/high-dose arabinoside

目的对中、大剂量阿糖胞苷(ID/HDAra蛳C)为主的化疗方案治疗急性非淋巴细胞白血病缓解期的疗效进行研究。方法化疗前用MTT法测定骨髓病变细胞对不同浓度Ara蛳C的药物敏感性,化疗时测定其血药浓度及脑脊液中药物浓度,观察疗效及毒副作用。结果93.3%患者骨髓病变细胞对高浓度Ara蛳C敏感,其中28.6%对中浓度Ara蛳C敏感,所有患者对低浓度Ara蛳C不敏感。血浆中Ara蛳C浓度随滴注时间逐步上升,滴注结束后迅速下降,药物可顺利通过血脑脊液屏障,该治疗毒副反应轻。结论ID/HDAra蛳C治疗既可强烈清除缓解后体内残留的肿瘤细胞,又能有效预防中枢神经系统白血病,且毒副作用小,在体内代谢快,无药物累积。

Objective To study on the therapeutic efficacy of patients with acute myeloid leukemia in remission treated with intermediate/high- dose arabinoside were performed. Methods MTT mothod was used prior to therapy to determine the sensitivity of disease cells in bone marrow to different concentrations of drug. Drug concentrations in blood and cerebrospinal fluid were monitored during the courses of treatment. The therapeutic efficacy and the side effects were also observed. Results The disease cells from most majority patients (93.3 %) showed sensitiveness to Ara- C in high concentration. 28.6 % among them showed sensitiveness to arabinosides of intermediate concentration, and insensitiveness to low- dose arabinoside in all patients. The plasma drug concentration increased gradually with time, and decreased rapidly after the infusion was completed, without severe toxic effects observed. Conclusions Intermediate/high-dose arabinoside can effectively eradiate the risidual disease cells and prevent central nerve leukemia with little toxic effects due to the rapid metabolism of the drug and without drug accumulations in bodies.